The Peripheral Perfusion Index tracks systemic haemodynamics during general anaesthesia

• Published in: Journal of clinical monitoring and computing 2020-12, Vol.34 (6), p.1177-1184
• Main Authors: Højlund, J., Agerskov, M., Clemmesen, C. G., Hvolris, L. Edvardsen, Foss, N. B.
• Format: Article
• Language: English
• Subjects: Anesthesiology; Critical Care Medicine; Health Sciences; Intensive; Medicine; Medicine & Public Health; Original Research; Statistics for Life Sciences
• ISSN: 1387-1307; 1573-2614
• DOI: 10.1007/s10877-019-00420-x

Stable intraoperative haemodynamics are associated with improved outcome and even short periods of instability are associated with an increased risk of complications. During anaesthesia intermittent non-invasive blood pressure and heart rate remains the cornerstone of haemodynamic monitoring. Continuous monitoring of systemic blood pressure or even -flow requires invasive or advanced modalities creating a barrier for obtaining important real-time haemodynamic insight. The Peripheral Perfusion Index (PPI) is obtained continuously and non-invasively by standard photoplethysmography. We hypothesized that changes in indices of systemic blood flow during general anaesthesia would be reflected in the PPI. PPI, stroke volume (SV), cardiac output (CO) and mean arterial pressure (MAP) were evaluated in 20 patients. During general anaesthesia but before start of surgery relative changes of SV, CO and MAP were compared to the relative changes of PPI induced by head-up (HUT) and head-down tilt (HDT). Furthermore, the effect of phenylephrine (PE) during HUT on these parameters was investigated. ∆PPI correlated significantly (p